Hazardous Materials Technician Skill Sheets - Pennsylvania Office Of The State Fire Commissioner Page 19
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22Hazardous Materials Technician 472
Test Date
Candidate #
STATION K –
Decontamination – Technical Decon
Reference NFPA 472 -
2013
Edition, Chapter 7
Test Site
Mandatory Station JPR 7.4.5 (1)(2), 7.1.2.2 (3)(b)(d),
7.4.2 (3)(4)
Directions:
Given a scenario and a simulated contaminated victim/personnel, all required PPE including
Respiratory Protection, decontamination supplies, and a decontamination line (layout) or using that of the AHJ, the
candidate while working as a member of a team will provide appropriate TECHNICAL decontamination of the
ambulatory and non-ambulatory victim/personnel while wearing appropriate PPE for the chemical identified in the
scenario
Performance Outcome: Pass/ Fail will be determined by 10 of the 13 items being preformed correctly
Initial Test
Retest
No.
Task Steps
Yes
No
Yes
No
1.
Candidate established Control Zones (hot, warm, cold)
2.
Candidate established ICS
Candidate assisted in identifying the appropriate levels of PPE
3.
required of Mass decon team.
Candidate properly donned appropriate level of protective clothing.
___ all closures and straps are secured
___ don’s SCBA, face piece with all straps secured
___ checks face piece for seal, confirms exhalation valve
operation
___ connects to regulator/face piece
___ opens cylinder valve fully, opens main line valve fully (if
4.
applicable)
___ checks donning mode switch (if applicable)
___ hand and foot protection on
___ helmet with chin strap in place/ hard hat secured
Candidate properly donned appropriate level of protective clothing.
[Circle One]
Level A
Level B
Candidate assisted in preparation and lay out of decon line.
5.
Decon set-up was in accordance with jurisdiction’s procedure.
Candidate prepared to function as a decon sector member
6.
Candidate performed technical decon. appropriately
7.
[Circle One]
Ambulatory victims
Non-ambulatory victims
___ instructs contaminated person through Gross decon.
___ instructs contaminated person to move to wash station,
performs wash from head to feet using appropriate method
___ instructs contaminated person to move to rinse station,
performs rinse from head to feet properly flushing under
arms, groin area, and flushing feet while victim moves to a
safe area for doffing of PPE and medical evaluation.
Continued on next page
July 2014
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